Dr. Radosveta Stamenkova: We hope for at least a 30% increase in the number of people vaccinated against HPV

Dr. Radosveta Stamenkova is the Executive Director of the Bulgarian Family Planning and Sexual Health Association – a leading non-governmental organization working for over 30 years for health prevention and information, peer education, reproductive health and advocacy for the causes of vulnerable groups. Dr. Stamenkova is also among the founders of the expert HPV Coalition, whose cause is the prevention and eradication of diseases related to the human papillomavirus (HPV). We talk to Dr. Stamenkova about the renewed information campaign of the HPV Coalition for the prevention of human papillomavirus-related cancers through vaccination, as well as about the new project of the Bulgarian Family Planning and Sexual Health Association, also related to HPV prevention.

– Dr. Stamenkova, what are the deficits in the awareness of children and young people about the Human Papillomavirus (HPV) and what are the consequences of this ignorance?

– The deficits are the same as with any other topic related to our health, as there is a lack of health education, a lack of adequate information and, accordingly, a lack of public attitudes towards prevention. Unfortunately, the lack of information about the human papillomavirus (HPV), about what diseases it causes and how they can be prevented, is present in both children and their parents. People are enslaved to myths, fake news is accepted as fact and the essence of the problem is not understood.

– What is the new project that the Bulgarian Family Planning and Sexual Health Association launched on November 1, 2025?

– The new project is called HUMANCODE and will be implemented by five partners within three years in three countries – Bulgaria, Romania and Ukraine. The lead partner in our country is the Thracian University in Stara Zagora. In Romania it is the Medical University in Targu Mures, and in Ukraine – the Multi-profile Hospital in the city of Volodymyrets and the non-governmental organization “School for Responsible Parents”. So, two NGOs, two medical universities and one hospital will work together. We all have experience in improving public health, in prevention and working with vulnerable groups. The idea is to be like the “companion of the ring” and reduce health inequalities in our three Eastern European countries. We will mainly work on the prevention of vaccine-preventable cancers related to HPV among vulnerable and socio-economically disadvantaged groups.

We aim to increase confidence in the HPV vaccine as the most effective tool for cancer prevention; to improve access to prevention and health services for hard-to-reach and marginalized communities – vulnerable youth, the Roma community, victims of military conflicts. Our work is mainly in the Roma community, with youth and their parents. But we will also work to strengthen the capacity of health professionals in conditions of vaccine hesitancy, in sensitive groups, as well as to promote cross-border cooperation and the exchange of good practices for protecting public health.

– What events will you organize under the project?

– We are planning trainings for general practitioners, obstetricians-gynecologists, healthcare specialists, students and medical residents on the importance of vaccination and the benefits of administering the Human Papilloma Virus vaccine. This way, we will have the confidence that general practitioners and gynecologists will be on our side, that they will share scientifically proven information. The idea is to go beyond the framework that the HPV vaccine only protects against cervical cancer, because it also protects against many other oncological diseases, 9 in number. To make it clear that it is extremely important to vaccinate both girls and boys, to overcome myths and fake news.

On the other hand, we have planned campaigns and information sessions in different communities, hoping for the help of health mediators in the Roma community and other structures with which we have been working for years in the field of reproductive health.

Our messages will be addressed to the so-called hesitators – to those often highly educated urban people who are prejudiced against vaccines.

As part of the project, we will purchase HPV vaccines for young people who are not covered by the National Program for Vaccine Prevention of HPV-related Cancers. These are girls over 18 years old and boys over 15 years old who would like to get the vaccine, but cannot afford it because of its price (two doses cost approximately 140 euros).

We will make and distribute an informational video on social networks about how useful the HPV vaccine is. We have experience in bringing health messages to people in an accessible and interesting way.

We will try to share our experience with our colleagues from Ukraine and Romania, and we hope to learn from their good practices. Because such regional initiatives have a synergistic, potentiating effect.

– What specific results do you expect?

– We expect to improve awareness and health culture in the target groups, to train 180 specialists, to increase HPV vaccine coverage by 30%, to stimulate 5,000 people to get vaccinated and to achieve at least 1,000 vaccinated people with our efforts (in total for the three countries). We hope to improve coordination between institutions, non-governmental organizations and health facilities in order to create practically applicable prevention models that will continue to work after the end of the project, while expanding their scope.

– You are among the founders of the HPV Coalition. How do you assess the expansion of the scope of the National Program for Primary Prevention of Cancers Associated with the Human Papilloma Virus – with the inclusion of girls from 10 to 18 years old and boys from 10 to 14 years old?

– Extremely positive. And although it may sound immodest, this happened largely thanks to the efforts of the HPV Coalition. It is no longer a taboo idea that boys should also be vaccinated. We have a list of general practitioners who can administer HPV vaccines to people who are not on their patient lists. This is a solution if your GP for some reason does not share the modern scientific and adequate attitude towards the HPV vaccine.

At the same time, we are very disappointed that the large European initiative SHIELD (Shield) for HPV prevention will take place in 25 EU member states, and only Bulgaria is not among them. The European Union is investing 20 million euros in the project, which means 800,000 euros per country for three years. Bulgaria is outside the project because the Ministry of Health did not react when it was invited to participate. It is sad because these are lost benefits due to the lack of interest of the experts from the Ministry of Health.

– Over 30,000 children have been born to minors in the last 10 years in Bulgaria? What are the consequences of the phenomenon of “children giving birth to children”?

– In some cases, this happens in the Roma community. I should clarify that in the Roma community there are different groups and people have different religions, mother tongues, traditions… The children of some of these groups of people stay in school and a large part continue their education at universities. But in some places, girls are still stopped from school when they turn 12-13 and have their first menstruation, and a little later they are married off. This means that they cannot realize their educational plans, respectively, they cannot be realized on the labor market. Thus, any personal realization is limited and they stay at home to raise children. Physical disadvantages are also a problem – a girl at 13 or 15 is not ready either physically or mentally to be a mother and to have two or three children by the age of 18.

That is why the phenomenon of “children giving birth to children” must be minimized until it disappears through education and impact on the entire community. It is not enough to motivate a girl to stay in school after the 7th grade. Her parents must be motivated not to stop her. The entire community must be motivated so that there is no pressure from the environment on the parents: “You just left your daughter in school, she will become a mess.” The phenomenon of children giving birth to children reflects the lack of health education in children and parents.

These little brides usually start a sexual life after they get married. The idea of ​​protecting against unwanted pregnancy, of protecting against sexually transmitted infections does not apply to them, since things happen in the family.

Of course, early marriages are nothing new. Our great-great-great-grandmothers gave birth at 14. Juliette died of love at 14, and her mother was 28 years old. But now the average life expectancy is not 35-40 years, as it was until the beginning of the 19th century, but 80 years, and we must prepare ourselves adequately for a longer life. Preparing for a life with a horizon of 40 years means giving birth at 14. And preparing for a life with a horizon of 80 years means staying in the education system as long as possible in order to be adequate to the time in which you live.

Mara Kalcheva, Patient Portal